Retzius Sparing Robotic Radical Prostatectomy

What is retzius sparing prostatectomy?

Robotic Retzius-sparing radical prostatectomy is a minimally invasive surgical technique for the treatment of prostate cancer. The procedure involves the use of a surgical robot to remove the prostate gland while sparing the Retzius space, which is a potential space located between the bladder and the prostate gland.

During the RRP procedure, the surgeon makes several small incisions in the patient’s abdomen and inserts small surgical instruments and a camera attached to the robotic arms. The surgeon then uses the robotic arms to carefully remove the prostate gland while preserving the surrounding nerves, blood vessels, and muscles.

By sparing the Retzius space, this technique aims to reduce the risk of urinary incontinence and erectile dysfunction, which are common side effects of traditional prostatectomy procedures. The robotic-assisted approach allows for greater precision and control during surgery, which can result in better outcomes for patients.

What evidence is there for retzius sparing prostatectomy?

We have published work on the Retzius-sparing technique for prostatectomy, which involves preserving the Retzius space during surgery to minimize damage to the urinary sphincter and improve postoperative continence outcomes.

In our research, we compared Retzius-sparing prostatectomy to traditional approaches and found that the Retzius-sparing technique resulted in better early continence outcomes and lower rates of urinary incontinence at 3 and 12 months after surgery. We also found that the Retzius-sparing approach did not increase the risk of positive surgical margins or complications.

What are the potential advantages of retzius sparing technique?

Here are some potential advantages of Retzius sparing radical prostatectomy compared to standard robotic radical prostatectomy:

1. Lower risk of urinary incontinence: Retzius sparing prostatectomy may result in less damage to the muscles and nerves that control bladder function, leading to a lower risk of urinary incontinence after surgery.
2. Faster recovery of continence: Patients who undergo Retzius sparing prostatectomy may regain urinary control more quickly than those who have standard robotic prostatectomy.
3. Improved sexual function: Retzius sparing prostatectomy may also help preserve erectile function by minimizing nerve damage during surgery.
4. Reduced blood loss: patients undergoing retzius sparing prostatectomy lost less blood on average than those undergoing standard robotic prostatectomy
5. Shorter operation time: retzius sparing surgery tended to be quicker on average than standard prostatectomy meaning less time under anaesthesia. 

What are the potential disadvantages of retzius sparing technique?

Although retzius-sparing radical prostatectomy has gained popularity in recent years, there are still some potential disadvantages to consider:

1. Increased surgical difficulty: Retzius-sparing prostatectomy is a technically demanding procedure that requires specialized surgical skills and expertise.
2. Potential for nerve damage: Although the Retzius-sparing technique aims to preserve the neurovascular bundle, there is still a risk of nerve damage that can lead to erectile dysfunction or other sexual problems.
3. Limited long-term data: While early studies have shown promising results, there is still limited long-term data on the efficacy and safety of Retzius-sparing prostatectomy. As with any new surgical technique, it will take time to fully understand the potential benefits and drawbacks of the procedure.
4. Not suitable for all patients: The Retzius-sparing technique may not be suitable for all patients, particularly those with larger prostates or more advanced cancer. The surgeon will need to carefully evaluate each patient’s case to determine whether this technique is appropriate.

Overall, Retzius-sparing prostatectomy is a promising technique that has the potential to improve outcomes for some patients. However, it is important to carefully consider the potential disadvantages before choosing this approach, and to discuss the risks and benefits with a qualified healthcare provider.